| International journal of Gynecology, Obstetrics and Neonatal Care (Volume 1 Issue 1) | |
| Do Polyps Matter? |  |
| Pages 1-5 A. Alalade, B. Coupe and G.O. Abdulrahman, Jnr. DOI: http://dx.doi.org/10.15379/2408-9761.2014.01.01.1Published: 29 August 2014 |
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| Abstract | |
| Introduction: Endometrial polyps (EP) are common within the gynaecological practice. The aims of this study are to evaluate the risk of premalignant and malignant changes in EP and to determine the predictors of histological outcomes of these lesions. Methods: This is a retrospective study conducted over a 12-year period between January 2000 and 2012. Data were retrieved from patients’ and theatre records. The histopathology reports of all cases were retrieved. All cases with confirmed EP at hysteroscopy were identified. Results: There were a total of 397 cases. Age range was between 24 and 89 years, median age at presentation was 54 years. Histology outcomes were classified into benign, premalignant (hyperplasia with atypia) and malignant. Age greater 60 years was strongly associated with abnormal histology i.e. premalignant and malignant changes in polyps (OR 2.174 [CI 1.645-2.874], p<0.001) Menopausal status showed a strong link with abnormal histology (OR 1.599 [CI 1.388- 1.842], p<0.001). These patients were about one and a half times more likely to have abnormal histology in the event of a polyp. The results are similar with premalignant histology (OR 1.610 [CI 1.394- 1.860], p<0.001). Results for patients presenting with postmenopausal bleeding were also positive. They were more likely to have abnormal histology compared to patients with other symptoms (OR1.776 [CI 1.516-2.079], p<0.001). Postmenopausal bleeding is also strongly associated with premalignancy (OR 1.782 [CI 1.515- 2.096], p<0.001). The use of hormone replacement therapy (HRT) or tamoxifen was not associated with abnormal histology (p= 0.114 and p=0.668 respectively) or premalignancy (p= 0.138 and p= 0.764 respectively). Polyps greater than 15mm were not associated with abnormal histology (OR 1.313 [CI 0.932-1.850], p= 0.143) or premalignancy (OR 1.292 [CI 0.896-1.864], p= 0.196). Conclusion: There is a strong link between patients’ age and menopausal status with abnormal or premalignant histology. Postmenopausal bleeding is also an important predictor of abnormal or premalignant changes at histology. |
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| Keywords | |
| Endometrial polyp, Abnormal histology, Premalignancy, Tamoxifen, Hormone replacement therapy, Postmenopausal. | |
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